Provider Demographics
NPI:1760651400
Name:S & S PHARMACY SERVICES, LLC
Entity Type:Organization
Organization Name:S & S PHARMACY SERVICES, LLC
Other - Org Name:SENIORCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:704-545-8641
Mailing Address - Street 1:4455 MORRIS PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-9207
Mailing Address - Country:US
Mailing Address - Phone:704-545-8641
Mailing Address - Fax:704-573-8344
Practice Address - Street 1:4455 MORRIS PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-9207
Practice Address - Country:US
Practice Address - Phone:704-545-8641
Practice Address - Fax:704-573-8344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4892290001Medicare NSC
SC4892290001Medicare NSC
TN4892290001Medicare NSC